An online chat on benefits and changes under the Health Care Law conducted by the Los Angeles Times Thursday, February 17 discussed changes to the new Health Care Law advocated by the American Medical Association (AMA), and featured the results of two polls. One showed that 92% of respondents opposed tossing out the new Health Care Law passed by Congress and signed into law by President Obama, but 50% favored some changes to the law while continuing to cover the uninsured. The other poll showed that 67% of respondents favored tort reform for medical malpractice claims. The chat was moderated by Chicago Tribune health reporter Bruce Japsen.

The featured panelist and presenter was Dr. Cecil Wilson, President of the American Medical Association (AMA). Dr. Wilson is an internist from Winter Park, Fla., and the 165th President of the AMA. The full script of the chat is available online at the LA Times.

Dr. Wilson explained that in the AMA’s view, “Congress [in the new health care law] made important changes to our nation’s health care system that will help patients and the physicians who care for them by extending health coverage to tens of millions of uninsured, improving competition and choice in the insurance marketplace, promoting prevention and wellness, reducing administrative burdens, and promoting clinical comparative effectiveness research.”

“But,” he said, “more work needs to be done. 2011 will be an important year in health care, and the AMA is working actively with Congress, the administration and federal agencies, on a variety of issues critical to reducing health care costs, ensuring patients access to physician care, and supporting innovations that will move our health system into the future.”

The first poll presented during the chat showed that when asked the question:

“Now that certain health benefits are available under the law and the new Congress has discussed potential changes, how should Congress act? ” —

fully 92% of respondents favored leaving the bill alone and making no changes, or making some changes but continuing to cover the uninsured. The results broke down as follows:

42% of the respondents said: Make no changes. Leave the bill alone.

50% of the respondents said: Make some changes but continue covering unisured.

Only 8% of respondents said: Toss out the bill and start over.

The LA Times chat did not explain how this poll was conducted, how many respondents participated, or the composition of the survey sample. However, inclusion of these survey results within the chat script without further explanation may suggest that they were results of an informal poll taken of participants during the online chat.

The primary focus of the chat was on changes to the health care law favored by the AMA, which represents doctors and medical care providers. The Moderator and Dr. Wilson both pointed out that President Barack Obama has said that he is open to certain changes in the law as long as they improve the law and don’t take away certain benefits. And, the President has indicated that he would be willing to work with newly elected Republicans in Congress on such changes to the legislation.

Dr. Wilson identified three areas in which the AMA seeks changes in the new health care law. “The key issues in the health reform law that deserve attention,” he said, “include [1.] protecting access to physicians with a permanent fix for the Medicare payment formula, [2.] comprehensive medical liability reform, and [3.] ensuring physician participation in new models of care, such as accountable care organizations.”

In response to a question as to what are “accountable care organizations,” Dr. Wilson explained, “The idea of an Accountable Care Organization (ACO) is a group of health professionals, led by physicians, who agree to take responsibility for a group of patients to help control the cost of medical care while improving the quality of care. This is done through improvements including increased coordination of care, providing the right care at the right time in the right setting, increasing preventive care and wellness, and following scientific guidelines.”

Another question asked, “What are the most critical wellness services that will become available [under the new health care law - the Patient Protection and Affordable Care Act]?” Dr. Wilson said, “The Affordable Care Act recognized that we as a society need to make wellness and preventive care a priority. It provides a mechanism to look at ways we can make that happen by focusing on those important areas that we know make a difference, such as obesity, cigarette smoking, alcohol abuse, sedentary lifestyle, and immunizations.”

As to the second area of AMA concern, Dr. Wilson explained the AMA’s position favoring comprehensive medical malpractice liability reform. He cited studies which have reportedly shown that two-thirds of medical malpractice claims are typically dropped or dismissed and referred to a Harvard study which, he said, found that up to 40% of claims “lack any evidence of either a medical error or patient injury.” He stated that, “The AMA supports proven reforms like those in the bi-partisan HEALTH Act (HR 5) that allow unlimited payment for economic damages, while capping non-economic damages at a quarter of a million dollars.”

A second poll was then featured during the chat. It showed that when asked the question: “Should patients who are harmed by medical malpractice have the non-economic damages be capped at a certain threshold? In California, for example, such damages are capped at $250,000 per claim? — 67% of respondents said “Yes,” and 33% said “No.” Again, the genesis of this poll or the composition of the participants was not explained. However, inclusion within the chat script may suggest that it was an informal poll of participants during the online chat.

During the discussion, Dr. Wilson also explained at some length the AMA’s position regarding “fixing” physician payments under Medicare. He said that, “The importance of fixing Medicare physician payments is to ensure that physicians can continue to see Medicare patients.”

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